NEW YORK (Reuters Health) - In patients with rheumatoid
arthritis, prolonged use of arthritis medications such as
methotrexate, glucocorticoids, and inflammation-suppressing
TNF-alpha blockers may protect the heart, researchers report.

"Our study," Dr. Antonio Naranjo told Reuters Health,
"demonstrated that the time of exposure both to
disease-modifying anti-rheumatic drugs and biological agents is
associated with a reduction of the risk of cardiovascular
events."

Naranjo, of the University of Las Palmas de Gran Canaria,
Spain, and colleagues came to this conclusion after studying
more than 4300 rheumatoid arthritis patients from 15 countries.

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The researchers found that most traditional risk factors,
such as high blood pressure, high cholesterol and diabetes were
significantly associated with the risk of cardiovascular
disease, but obesity and being physically inactive were not.

The team also found a link between the presence of
manifestations of rheumatoid arthritis outside the joints, such
as inflammation of blood vessels, and heart attack. Being male
also carried a higher risk for any cardiovascular event.

However, after adjustment, the researchers found that
prolonged exposure to certain anti-arthritis agents -- namely,
methotrexate, leflunomide, sulfasalazine, glucocorticoids and
biologic agents -- substantially reduced the risk of
cardiovascular death.

"Methotrexate, other disease-modifying anti-rheumatic drugs
and biologic agents could reduce the extra risk of myocardial
infarction (heart attack) and stroke that patients with
rheumatoid arthritis have, through the control of
inflammation," suggested Naranjo

"The practical consequence of our work," he added, "is that
in patients with rheumatoid arthritis, especially in the most
severe cases, there has to be control of both the classic
cardiovascular risk factors and the inflammatory activity of
the disease."